Please be assured that Minnesota Official Measurers is strictly a Measuring Club and is only interested in bringing Quality Pictures and Information pertaining to measuring your trophy's to other members of the Hunting Public. Please copy and print this form along with the information about your photo submission that you would like posted on the M.O.M. Website. Also remember to sign and date the form and enclose your pictures for submission. No photos will be returned and no compensation will be given for any submissions made to Minnesota Official Measurers. We are a Non-Profit Organization and only want to give you a site that offers a glimpse into some of the magnificent trophy's that you and your fellow hunters have harvested.
                    
     www.mnmom.com     Release of Personal Information for Photo Submission and/or Measurers Information     www.mnmom.com

                                                        Minnesota Official Measurers (M.O.M.) Web Site

I, ____________________, give my permission for Minnesota Official Measurers to use the following personal information to be posted on the Minnesota Official Measurers web site.  I understand that any and all information given will be used solely for use on the web site and will not be shared in any other form or with any other organization.

 Do you wish to display any or all of the information listed below?

 Name:                 ____NO   IF YES: ___________________________________________
 Address:        ____NO   IF YES: STREET____________________________________                     CITY___________________STATE______ZIP____

 Phone Number:   ____NO   IF YES: ___________________________________________

 Cell Number:      ____NO   IF YES: ___________________________________________

 E-mail Address:  ____NO   IF YES: ___________________________________________

 Qualifications:     ____NO  IF YES: Please check all that apply: B&C ______, P&Y_____,
  MDHA and Deer Classic _____, Longhunters ______,
   Shed Antler Record Book ______, Others (please list)
  ______________________   ____________________

 Photo/Likeness    ____NO  IF YES: _____ Enclosed.  (a picture with you in it may, or can, be used when a picture is posted on the web site while someone or yourself is holding a shed antler, skull, or rack.  Also, pictures may be posted from special events
such as, but not limited to training classes, meetings, fishing derbies, etc.)  We wish to thank you for your interest in developing our M.O.M. Website and hope to see your approved photos on our website pages.

 Please be assured that Minnesota Official Measurers is strictly a Measuring Club and is only interested in bringing Quality Pictures and Information pertaining to measuring your trophy's to other members of the Hunting Public. Please copy and print this form along with the information about your photo submission that you would like posted on the M.O.M. Website. Also remember to sign and date the form and enclose your pictures for submission. No photos will be returned and no compensation will be given for any submissions made to Minnesota Official Measurers. We are a Non-Profit Organization and only want to give you a site that offers a glimpse into some of the magnificent trophy's that you and your fellow hunters have harvested.

 I also have the following request(s) pertaining to my personal information.  (Please write or print legibly)   __________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

 Signature:________________________________  Date: _______________________________

                ********  Please return to: Mark Sieg, 8638 Ogren Ave., Elk River, Mn.  55330  ********

                                               Minnesota Official Measurers     www.mnmom.com